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Organization

MEDICAL XRAY CENTER PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. GERALD LLOYD LARSON (BUSINESS ADMINISTRATOR)
(605) 731-7522
Entity
Organization

Contact information

Practice address
1417 S MINNESOTA AVE, SIOUX FALLS, SD 57105-1715
(605) 336-0517
(605) 336-2874
Mailing address
1417 S MINNESOTA AVE, SIOUX FALLS, SD 57105-1715
(605) 336-0517
(605) 336-2874

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
2085R0202X
Diagnostic Radiology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7202240
SD
Enumeration date
02/05/2007
Last updated
10/25/2007
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